Share your information with Shadale Jacobs

Shadale Jacobs

Jacobs Joyful Journeys

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    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="Let&#39;s Get Started Planning your trip to Aruba! (July 22, 2026 - July 26, 2026)"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country of Citizenship" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Primary Traveler Date of Birth" name="primary-traveler-date-of-birth" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="American Airlines AAdvantage account (if applicable)" name="american-airlines-aadvantage-account-if-applicable" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Traveler #2 - Full Name as it appears on Government Issued Photo ID" name="traveler-2-full-name-as-it-appears-on-government-issued-photo-id" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Traveler #2 - Date of Birth" name="traveler-2-date-of-birth" className="form-control"/>&#13;
		<field type="text" label="Traveler #2 - American Airlines AAdvantage account (if applicable)" name="text-1770257842360" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you wish to alter the dates of travel (extend or shorten)? If so, please indicate the dates of travel.&amp;nbsp;" description="The Marriage Matters PTO Trip is scheduled from July 22 - July 26, 2026. " name="do-you-wish-to-alter-the-dates-of-travel-extend-or-shorten-if-so-please-indicate-the-dates-of-travel-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Preference for # of Flight Stops" name="preference-for-of-flight-stops">&#13;
			<option label="Non-Stop" value="nonstop">Non-Stop</option>&#13;
			<option label="1 Stop" value="1-stop">1 Stop</option>&#13;
			<option label="Best Price" value="best-price">Best Price</option>&#13;
			<option label="Shortest Travel Time" value="shortest-travel-time">Shortest Travel Time</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Preferred earliest flight departure time (Departure)" name="preferred-earliest-flight-departure-time-departure">&#13;
			<option label="Early Morning (before 6am)" value="early-morning-before-6am">Early Morning (before 6am)</option>&#13;
			<option label="Morning (6:00am - 8:00am)" value="morning-600am-800am">Morning (6:00am - 8:00am)</option>&#13;
			<option label="Mid Morning (8:00am - 10:00am)" value="mid-morning-800am-1000am">Mid Morning (8:00am - 10:00am)</option>&#13;
			<option label="Late Morning (10:00am - 12:00pm)" value="late-morning-1000am-1200pm">Late Morning (10:00am - 12:00pm)</option>&#13;
			<option label="Afternoon (12:00pm - 2:00pm)" value="afternoon-1200pm-200pm">Afternoon (12:00pm - 2:00pm)</option>&#13;
			<option label="Late Afternoon (2:00pm - 4:00pm)" value="late-afternoon-200pm-400pm">Late Afternoon (2:00pm - 4:00pm)</option>&#13;
			<option label="Evening (4:00pm -6:00pm)" value="evening-400pm-600pm">Evening (4:00pm -6:00pm)</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Preferred earliest flight return time (Return Flight)" description="What time would you like to leave Aruba?" name="preferred-earliest-flight-return-time-return-flight">&#13;
			<option label="Early Morning (before 6am)" value="early-morning-before-6am">Early Morning (before 6am)</option>&#13;
			<option label="Morning (6:00am - 8:00am)" value="morning-600am-800am">Morning (6:00am - 8:00am)</option>&#13;
			<option label="Mid Morning (8:00am - 10:00am)" value="mid-morning-800am-1000am">Mid Morning (8:00am - 10:00am)</option>&#13;
			<option label="Late Morning (10:00am - 12:00pm)" value="late-morning-1000am-1200pm">Late Morning (10:00am - 12:00pm)</option>&#13;
			<option label="Afternoon (12:00pm - 2:00pm)" value="afternoon-1200pm-200pm">Afternoon (12:00pm - 2:00pm)</option>&#13;
			<option label="Late Afternoon (2:00pm - 4:00pm)" value="late-afternoon-200pm-400pm">Late Afternoon (2:00pm - 4:00pm)</option>&#13;
			<option label="Evening (4:00pm -6:00pm)" value="evening-400pm-600pm">Evening (4:00pm -6:00pm)</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Flight Seating Location Preference" name="flight-seating-location-preference">&#13;
			<option label="Front" value="front">Front</option>&#13;
			<option label="Mid" value="mid">Mid</option>&#13;
			<option label="Back" value="back">Back</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Flight Seating Preference" name="flight-seating-preference">&#13;
			<option label="Aisle and Middle" value="aisle-and-middle">Aisle and Middle</option>&#13;
			<option label="Aisle and Window" value="aisle-and-window">Aisle and Window</option>&#13;
			<option label="Window and Middle" value="window-and-middle">Window and Middle</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Select Room Type" name="select-room-type">&#13;
			<option label="Deluxe" value="deluxe">Deluxe</option>&#13;
			<option label="Deluxe Ocean View" value="deluxe-ocean-view">Deluxe Ocean View</option>&#13;
			<option label="Deluxe Pool Ocean View" value="deluxe-pool-ocean-view">Deluxe Pool Ocean View</option>&#13;
			<option label="Royal Level Luxury Ocean View" value="royal-level-luxury-ocean-view">Royal Level Luxury Ocean View</option>&#13;
			<option label="Royal Level Suite Oceanview (+$4200.00)" value="royal-level-suite-oceanview-420000">Royal Level Suite Oceanview (+$4200.00)</option>&#13;
			<option label="Most Affordable Option" value="most-affordable-option">Most Affordable Option</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Round Trip Ground Transfer Add-on" name="round-trip-ground-transfer-addon">&#13;
			<option label="Private Round Trip ($187.83 max 4 ppl)" value="private-round-trip-18783-max-4-ppl">Private Round Trip ($187.83 max 4 ppl)</option>&#13;
			<option label="Shared Round Trip (29.48 per person)" value="shared-round-trip-2948-per-person">Shared Round Trip (29.48 per person)</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Pre Departure Protection ($90 Per Person) The Pre-Departure Protection (PDP) waiver allows you to revise your booking up to and including the 8th day prior to departure or to cancel the booking entirely at any time prior to your originally scheduled departure time without incurring revision or cancellation fees." name="pre-departure-protection-90-per-person-the-predeparture-protection-pdp-waiver-allows-you-to-revise-your-booking-up-to-and-including-the-8th-day-prior-to-departure-or-to-cancel-the-booking-entirely-at-any-time-prior-to-your-originally-scheduled-departure-time-without-incurring-revision-or-cancellation-fees">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you like a quote for additional Travel Insurance? (highly recommended)" description="Travel insurance is offered through Allianz." name="would-you-like-a-quote-for-additional-travel-insurance-highly-recommended">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
	</fields>&#13;
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